IU GERIATRICS
PREMIER ISSUE
campus-based programs, and built a size- able cadre of interdisciplinary specialists in geriatric care. These clinical venues and faculty are being used to provide a greater and more structured education in Geriatrics for our students, residents, fellows, and faculty.
Furthermore, the entire program is closely dovetailed with the health services research activities in the Center for Aging Research. This Center was started with the assistance of the Indiana
University Strategic Directions Initiative and major support from the Regenstrief Institute for Health Care. Additional philanthropic support established three endowed chairs—the Cornelius and Yvonne Pettinga Chair in Aging Research, the Mary Elizabeth Mitchell Chair in Geriatrics, and the Richard M. Fairbanks Chair in Aging Research.
The research focus for the Center’s 11 core investigators is geriatric health services and behavioral research. Their investigations test new strategies to im- prove and measure the quality of health care and the quality of self-care. Along with the Center’s 23 affiliated scientists, their vision is to build an interdiscipli- nary community of scholars whose creativity and scientific excellence leads to improved health for older adults.
The development of these twin programs is a major source of pride for our Department, School, University and State. I look forward to the continued leadership of the Geriatrics Program and Center for Aging Research as they help us all to provide higher quality care to older adults.
By David W. Crabb, M.D.
Chairman, Department of Medicine Indiana University School of Medicine The demographics of aging are by now familiar to most of us. There are 900,000 adults aged 65 and older living in the State of Indiana. In another 30 years, this number will nearly double.
Although older adults comprise about 12% of our state population, they account for nearly 40% of all health care expenditures. Internal
Medicine physicians will spend about 50% of their professional time in the care of older adults.
In the mid-1990s, the leadership at Indiana University recognized the implications of this aging imperative. Led by faculty in the Department of Medicine, the university initiated a new Geriatrics
Program in the Division of General Medicine, now known as the Division of General Medicine and Geriatrics and headed by William M. Tierney, M.D.
This program, now in its fifth year, has produced a dramatic expansion in our efforts to improve the quality of health care for older adults.
Through collaborative funding from the University, the Health Schools, Wishard Health Systems, the Regenstrief Institute for Health Care, local philan- thropy, and extramural grants, the Department of Medicine is now home to a nationally recognized and innovative program in Geriatric Medicine. The program has developed state-of-the-art clinical venues on campus, integrated a network of skilled nursing facilities and home health care initiatives with our
Programs Are Major Source of Pride
Spring, 2001 Volume 1, Issue 1
NEWSLETTEROFTHE INDIANA UNIVERSITY GERIATRICS PROGRAM & THEINDIANAUNIVERSITY CENTERFOR AGING RESEARCH
Steven R. Counsell, M.D.
Mary Elizabeth Mitchell Scholar in Geriatrics Associate Professor of Medicine
Director of Geriatrics Indiana University School of Medicine
[email protected] 317-630-6911
Christopher M. Callahan, M.D.
Cornelius & Yvonne Pettinga Scholar in Aging Research
Associate Professor of Medicine Director, Indiana University
Center for Aging Research Research Scientist
Regenstrief Institute for Health Care [email protected]
317-630-7200
It is mandatory for us to advance knowledge
about aging through research, and translate those findings into better care of aging patients
in our educational
activities.
Readers of the Indianapolis Star had the opportunity to meet Indiana University geriatrician Dr. Robin Beck when an edition of the newspaper focused on the House Calls for Seniors program. The paper shadowed Beck last winter as she called on her patient and his wife in their city home.
The main goal of the House Calls program is to reach the homebound who otherwise would not receive needed medical care. A team consisting of a geriatrician, a geriatric nurse practitioner, and a social worker all make home visits and spend time together each week reviewing their patients.
Operated by Wishard Health Services and IU Medical Group, the program is limited to elderly
patients who live near Wishard.
House Calls tries to keep seniors living in their homes as independently as possible. The need for home care in Indiana cannot be disputed—about 250,000 Hoosiers over age 65 have difficulty with activities of daily living such as bathing, getting dressed and walking.
Beck, the director of House Calls, returned to the Indiana University School of Medicine as a geri- atrician in the fall of 1999 with the goal of starting the service for seniors. She completed an Internal Medicine Residency at IU, followed by a Geriatrics Fellowship at the University of Wisconsin. Beck is board certified in Internal Medicine and Geriatrics.
In addition to performing clinical duties for House Calls, Beck spends a portion of her time supervising and teaching geriatric fellows, housestaff, and medical students about key areas of senior care such as osteoporosis, dementia, and drug prescrib- ing. As a member of the IU Geriatrics core faculty, she provides inpatient care in Wishard's Acute Care for Elders (ACE) Unit and outpatient care at the Geriatric Health Centers and the IU Center for Senior Health.
Beck Stars in House Calls Feature
The IU Geriatrics Program—Building a Strong Team
House Calls Team (left to right) Robin Beck, M.D., Donna Casper, M.S.W., L.S.W., Bruce Grau, R.N., G.N.P.
IU Geriatrics Program Faculty
Steven Counsell, M.D.
Robin Beck, M.D.
Amna Buttar, M.D.
Christopher Callahan, M.D.
Jeffrey Darnell, M.D.
David M. Smith, M.D.
Usha Subramanian, M.D.
Michael Weiner, M.D.
Glenda Westmoreland, M.D.
David Wilcox, M.D.
Neurology Ann Hake, M.D.
Neuropsychology
Frederick Unverzagt, Ph.D.
Palliative Care Program Greg Gramelspacher, M.D.
Physical Medicine &
Rehabilitation
Angela Carbone, M.D.
Psychiatry
Jeanne Dickens, M.D.
Urology
Thomas Gardner, M.D.
It takes a very strong diverse team to carry out a big vision. Consider the IU Geriatrics Program vision—
to provide quality clinical care for older Hoosiers, to provide needed geriatrics education and training experiences for medical students, residents, and fellows; and to investigate new treatments and health care delivery models for seniors.
Future issues of IU Geriatrics will present the program's clinical, educational and research activi- ties, but in this premier issue, we introduce readers to the Geriatrics Program faculty. The list includes faculty geriatricians as well as department specialists who work in clinical venues such as the IU Center for Senior Health, a multispecialty clinic providing consultation and primary care.
Complementing the faculty is an interdisciplinary team of geriatric nurse practitioners, clinical nurse specialists, social workers, physical and occupational therapists, pharmacists, dieticians, and chaplains.
They all work to improve the quality, efficiency, and integration of care to older adults and families who are coping with the medical, social, and emotional issues of aging.
While researchers await the final patient outcomes, clinical geriatrics providers hope the IMPACT project will make a difference in the lives of seniors who are patients in Wishard’s Adult Medicine Clinical Practice.
IMPACT—Improving Care for Late Life Depression—
tests the cost effectiveness of a multifaceted disease management program to improve the care of older adults with major depression or dysthymia. The project will determine if a primary care-based collaborative program will improve patient outcomes such as depres- sive symptoms, health related quality of life, quality of
care for depression, and satisfaction with depression care when compared to care as usual.
Funded by the John A.
Hartford Foundation and the California HealthCare Foundation, the clinical trial is conducted in 7 pri- mary care systems around the country. Christopher M. Callahan, M.D., is the principal investigator for the Indiana site.
After a patient’s recruitment into the study, the depression clinical specialist (DCS) conducts an initial assessment and provides patient education, activation, follow-up and case management. The DCS supports antidepressant medication therapy treatment by primary care providers and is trained to deliver a form of Problem Solving Therapy in primary care.
The collaborative team consists of a geriatric
psychiatrist, a geriatrician, and the DCS who coordinates all care for depression with the patient’s primary care physician. The team uses clinical judgment to ensure that patients enter a stepped care algorithm at the correct step and that each patient has a treatment plan that is best suited for his or her clinical circumstances and treatment preferences.
“While there is ample evidence that depression in late life can be successfully treated," notes Callahan,
"few older adults receive an adequate dose and duration of treatment in the primary care setting. With IMPACT we have the expectation that our collaborative team will achieve guideline-level care.”
The IU Center for Aging Research is pleased to announce the appointment of Hugh C. Hendrie, M.B., Ch.B., as Center Scientist. He joins the Center after seven months as its visiting professor.
Hendrie is professor of psychiatry and co-director of the Center for Alzheimer’s Disease and Related Neuropsychiatric Disorders at IUPUI.
He led the Department of Psychiatry as chairman from 1975-2000.
The Center for Aging Research is located at the Regenstrief Institute for Health Care where Hendrie is also a Research Scientist.
IU Center for Aging Research Core Faculty
Hendrie Joins Center for Aging Research Research Makes IMPACT in Primary Care
IMPACT Collaborative Team (left to right) Depression Clinical Specialist Cora West, R.N., A.N.P., Geriatrician Amna Buttar, M.D. , and Geriatric Psychiatrist Jeanne Dickens, M.D.
The goals of treatment for IMPACT are to achieve symptomatic
remission, full return of psychosocial functioning, and prevent relapse and
recurrence of depression.
Christopher Callahan, M.D., Director Neil Oldridge, Ph.D., Associate Director
Dan Clark, Ph.D., Director of Behavioral Sciences Research Steven Counsell, M.D., Director of Clinical Programs Siu Hui, Ph.D., Director of Biostatistics
Amna Buttar, M.D., Center Scientist Teresa Damush, Ph.D., Center Scientist Hugh Hendrie, M.B., Ch.B., Center Scientist Faryle Nothwehr, Ph.D., Center Scientist Wanzhu Tu, Ph.D., Center Scientist
Michael Weiner, M.D., M.P.H, Center Scientist
Geriatric Medicine Fellowship Journal Club
Third Monday 12-1 pm Fellows’
Core Lecture Series Featuring clinical topics First, second, fourth Monday
12-1 pm Located in
West Outpatient Bldg—M200 Wishard Hospital
Call 630-6145 for information
Geriatrics Bulletin Board
Learn the Latest in Clinical and Research Findings
Web sites
Center for Aging Research http://iucar.iu.edu
Geriatric Medicine Fellowship http://medicine.iupui.
edu/fellow.
html#Geriatric
Geriatric
Medicine Conference Geriatric faculty & guest speakers
First & third Wednesday Presentations by Residents
Fourth Wednesday 7:30-8:30 am Literature Review Abstracts reviewed by Clinical & research faculty
Second Wednesday 7:30-8:30 am Located in T2008 A&B
Wishard Hospital Call 630-6911 for information
on topics and accreditation
IU GERIATRICS
Editors
Nancy Nienaber Buchanan, M.A.
[email protected] 317-630-7915
317-630-6611 FAX Kathy Frank, R.N., M.S.N.
[email protected] 317-630-8183
IU Geriatrics welcomes your comments and ideas for articles.
To receive this newsletter, contact Buchanan at:
IU Center for Aging Research Regenstrief Institute, RG6 1050 Wishard Boulevard Indianapolis, IN 46202-2872
NON-PROFIT ORG U.S.
POSTAGE P A I D PERMIT #4245 Indianapolis, IN
